► International nonprofit workers follow a sense of purpose or calling to serve humanity in the far corners of the world. This study is a…
(more)

▼ International nonprofit workers follow a sense of purpose or calling to serve humanity in the far corners of the world. This study is a phenomenology of thriving in this population. Parallel to the broader mentalhealth field, there is a shift in focus from diagnosing pathology and reason for failure to promoting optimal functioning of this population. Positive psychology increased attention to optimal human function and the field of counseling has focused on wellness and development of people rather than treating pathology. This study has identified nine themes common to global workers who are thriving. Application is made to how workers and organizations can promote the well-being of global workers. Results are compared with established constructs of well-being.

► The purpose of the grant was to fund a mentalhealth awareness fair. The aim is to spread mentalhealth awareness, by reaching out…
(more)

▼ The purpose of the grant was to fund a mentalhealth awareness fair. The aim is to spread mentalhealth awareness, by reaching out to communities where people are underserved. Educating people about mentalhealth, would impact how people think of others dealing with mentalhealth issues. The grant would bring a resource fair that would showcase all service providers in both mental and physical health agencies in Los Angeles County, hosted by MentalHealth of America, Los Angeles.
Hosting a resource fair in Los Angeles County will give the community an opportunity to identify services available to them and/or their families. Service providers will be offer services such as depression screenings, blood pressure checks, HIV testing, healthy coping skills lists, and/ or sleep hygiene tips. It would also show the communities that service providers work together to serve the health of the whole person.

► Police strategies have transformed over the years. The prior approach of criminalizing mental illness by incarcerating those in mentalhealth crisis in jails was…
(more)

▼ Police strategies have transformed over the years. The prior approach of criminalizing mental illness by incarcerating those in mentalhealth crisis in jails was exposed to be ineffective. The development of partnerships between police officers and mentalhealth professionals was the next evolution in the law enforcement response to mental illness. This collaboration works in partnership to provide positive outcomes for those struggling with a mentalhealth crisis. This quantitative study evaluated the effectiveness of the co-response model by completing a secondary data analysis of pre-existing 2014-2015 data extracted from the Los Angeles Police Department (LAPD) Mental Evaluation Unit database documenting law enforcement encounters with consumers of mentalhealth services. Descriptive and inferential analyses were conducted on 15,454 records. Significant findings indicate that this new partnership has provided a positive impact in deterring the criminalization of persons with mental illness by directly connecting those persons to more appropriate treatment facilities to help them manage their symptoms and conditions.

► Despite its importance, little is known about how psychologists are trained to reflect on their conduct of psychotherapy. These abilities are collectively known as…
(more)

▼ Despite its importance, little is known about how psychologists are trained to reflect on their conduct of psychotherapy. These abilities are collectively known as reflective practice, which is considered a core competence within the field of psychology. This study examined the use of reflective practice by clinical, counseling, and school psychology interns and looked at how reflective practice is being facilitated by supervisors. The study examined the use of reflective practice in different clinical situations and obtained opinions about which reflective practices are believed to most impact clinical effectiveness. The study also examined barriers that may impede engagement in reflective practice. A mixed-method approach, including quantitative and qualitative analyses, was used to examine study questions in a sample of 69 pre-doctoral psychology interns. Results of this study indicated that for clinical cases in which the therapeutic work was “going well,” psychology interns engaged in reflective practice slightly more than once per month. However, for challenging cases (whether the “work was going well or not”) reflective practice was reported to increase, on average, to more than once per month, but less than once a week. There was no significant difference in frequency of reflective practices used between “challenging cases going well” and “challenging cases not going well.” This study found that supervisors facilitated an average of slightly over half of the total reflective practices measured. Further, the number of practices facilitated by supervisor was significantly correlated with the frequency of reflective practice use among interns. The reflective practices perceived to have the most impact on clinical effectiveness were (a) reflecting on feelings during session, (b) examining personal beliefs and values, and (c) reflecting on the quality of the therapeutic relationship. The most significant barrier to engagement in reflective practice was reported to be time. In regard to interns’ beliefs about how helpful reflective practice is to clinical practice, two major themes emerged: (a) whether reflective practice was helpful to the therapist (e.g., increased self-awareness) versus (b) if it was helpful to the client (e.g. helped client process their emotions more). Implications for future research and application to clinical practice are discussed.

► Previous research has established high mentalhealth problems and needs of children in residential care. However, in Zambia little is known about the mentalhealth…
(more)

▼ Previous research has established high mentalhealth problems and needs of children in residential care. However, in Zambia little is known about the mentalhealth of this peculiar group of children. The study prescribed in this paper aimed to explore the mentalhealth problems/disorders in residential care for street children and to examine the service response to their mentalhealth needs. The study utilized a sample of 74 (68 boys and 6 girls) street children in residential care aged 7-17 years. To collect data on children’s mentalhealth problems and needs, the Strengths and Difficulties Questionnaire (SDQ) was administered to agency carers and adolescents (if older than 11). Data on mentalhealth service provision was obtained from children’s case files and semi structured interviews with residential care managers. Nearly three quarters of street children in residential care were rated as having a mentalhealth problem, as indicated by findings from both the self rated SDQ and the Carers’ SDQ. Out of this sample, a considerable number (about one third) had multiple mentalhealth problems which indicated significant levels of impairment. The most frequent mentalhealth problems/disorders were behavioural and emotional problems. The study also found a strong relationship between multiple mentalhealth problems (co-morbidity) and the impact of these problems on the children. Residential care managers reported that there were no referral centres for children with complex mentalhealth problems. The study results also indicated that some residential centres lacked trained personnel to deal with mentalhealth problems among children and adolescents. In addition, all the residential centres had financial challenges to effectively implement programmes. The researcher concluded that street children in residential care are a high risk population to mentalhealth problems. In addition, children with multiple mentalhealth problems are likely to perform poorly in terms of social functioning compared with those with less or without mentalhealth problems. Further, the the mentalhealth services for street children in residential care were not matching to the needs of the children.

► Co-occurring disorder (COD) refers to concurrent psychiatric and substance use disorders (SUD). Compared to those with a single disorder, individuals with COD often require more…
(more)

▼ Co-occurring disorder (COD) refers to concurrent psychiatric and substance use disorders (SUD). Compared to those with a single disorder, individuals with COD often require more complex treatment, have poorer health outcomes, and incur higher treatment costs. Researchers have extensively studied both the high lifetime prevalence and age of onset for psychiatric disorders and SUD independently, but little is known about the social antecedents of COD, especially how these antecedents vary by race/ethnicity and gender. I expect the antecedents do not behave universally, though they are currently treated that way. Guided by the Stress Process Model, the Theory of Fundamental Causes, and the Life Course Perspective, this dissertation aims to better understand the role of childhood poverty and childhood adversity in the occurrence of COD for males and females, and for different racial/ethnic groups. This dissertation employs a secondary analysis of existing community-based survey data recorded in the National Epidemiologic Survey of Alcohol and Related Conditions III. Using multinomial logistic regression with a four-category variable for disorder (categories: COD, SUD only, psychiatric disorder only, no disorder), on a bivariate level, childhood poverty is associated with COD, however, with the addition of all other covariates there is no longer an association between poverty and COD. Childhood adversities are strongly associated with COD, net of other factors, in all of the models estimated. There are clear race/ethnicity differences in prevalence of disorder when COD is studied in the whole population. For COD relative to no disorder, Blacks, Asian Americans, and Hispanics, are all approximately half as likely as Whites to have COD, net of other factors. There are no conditional race/ethnicity relationships for COD. There are, however, gender differences in both disorder prevalence and the associations between childhood poverty and COD as well as childhood adversity and COD. Childhood poverty is associated with COD in opposite directions for males and females: for males it increases the relative risk ratio of COD compared to SUD, and for females it decreases the relative risk for this same comparison. This study found no moderation of the childhood poverty and COD relationship by number of adversities in the regressions conducted.Conducting a survival analysis with only respondents who have at least one disorder indicates that having psychiatric disorder compared to having SUD is associated with a 36% increase in the hazard ratio of subsequently developing COD overall. The significant conditional relationship between disorder sequence and gender shows that hazard of co-occurrence with a psychiatric disorder is higher for males than females. On the contrary, the hazard of co-occurrence when one has SUD is higher for females than it is for males.This research has clear public health relevance: above and beyond the genetic risk incurred by having a parent with a disorder, experiencing adverse events in childhood is…

vanDraanen Earwaker, J. M. (2017). The Association Between Childhood Poverty and Adversity and the Likelihood of Experiencing Co-occurring Psychiatric and Substance Use Disorders. (Thesis). UCLA. Retrieved from http://www.escholarship.org/uc/item/7sr6v8zp

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

vanDraanen Earwaker JM. The Association Between Childhood Poverty and Adversity and the Likelihood of Experiencing Co-occurring Psychiatric and Substance Use Disorders. [Thesis]. UCLA; 2017. Available from: http://www.escholarship.org/uc/item/7sr6v8zp

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

UCLA

7.
Lasky, Arielle.
Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD.

► Although much is known about the difficulties faced by children with ADHD in school settings, very little research has explored the functioning of adults with…
(more)

▼ Although much is known about the difficulties faced by children with ADHD in school settings, very little research has explored the functioning of adults with ADHD in work environments. Experimental studies demonstrate that certain contexts can significantly reduce ADHD symptom severity; we ask whether the lived experience of young adults with ADHD in different work settings parallels these findings. Are there particular occupations in which young adults report functioning better than others? To examine this issue, we interviewed 125 young adults, originally diagnosed with ADHD as children ages 7-9, regarding their current work environments. Many young adults reported that their symptoms are context-dependent; working in specific occupations, they feel less encumbered by their symptoms. In some of these environments, participants report feeling better able to focus; in others, their symptoms—such as high energy levels—become strengths rather than liabilities. Modal descriptions included work marked by high levels of stress or challenge, novel or varied tasks, a fast pace, hands-on work, physical labor, and/or work they found intrinsically interesting. For our subjects, ADHD is experienced as an interaction between themselves and their environment. These exploratory findings demonstrate the need to account for the role of context in our understanding of ADHD as a psychiatric disorder, especially as it manifests in young adulthood. Implications for clinical care and diagnostic conceptualization of the disorder are discussed.

Lasky, A. (2015). Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD. (Thesis). UCLA. Retrieved from http://www.escholarship.org/uc/item/1qz8t3h1

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Lasky, Arielle. “Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD.” 2015. Thesis, UCLA. Accessed September 15, 2019.
http://www.escholarship.org/uc/item/1qz8t3h1.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Lasky, Arielle. “Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD.” 2015. Web. 15 Sep 2019.

Vancouver:

Lasky A. Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD. [Internet] [Thesis]. UCLA; 2015. [cited 2019 Sep 15].
Available from: http://www.escholarship.org/uc/item/1qz8t3h1.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Lasky A. Occupation and ADHD: Young adults’ perspectives on the role of work in the manifestation of adult ADHD. [Thesis]. UCLA; 2015. Available from: http://www.escholarship.org/uc/item/1qz8t3h1

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

► Riverside County's Emergency Treatment Services is one of only a few psychiatric emergency rooms in the state, but the facility has not been able to…
(more)

▼ Riverside County's Emergency Treatment Services is one
of only a few psychiatric emergency rooms in the state, but the
facility has not been able to keep up with the fast-growing
population in the county. Seventeen years after it first opened,
doctors and other staff complain that conditions for patients are
intolerable.; Overcrowding in the emergency room forces doctors to
interview patients in group areas, compromising patient
confidentiality, and patients to sleep on the floor because there
are not enough beds or chairs. Doctors are also concerned about
their own fatigue, as the administration no longer allows
psychiatrists on overnight shifts to sleep when there are no
patients to be seen. These concerns have prompted the
administration to plan expansions to the physical space of the
facility, but the timeline for those improvements is in
question.
Advisors/Committee Members: Cray, Edward (Committee Chair), Melnick, Glenn (Committee Member), Kotler, Jonathan (Committee Member).

► Chronic pain is a significant problem in the U.S. pediatric population, conservatively estimated to affect 15% to 20% of children. Few studies have focused…
(more)

▼ Chronic pain is a significant problem in the U.S. pediatric population, conservatively estimated to affect 15% to 20% of children. Few studies have focused on coping strategies African American children use to manage chronic pain. The purpose of this study was to examine coping strategies used by African American children and adolescents ages 11 to 18 years suffering from chronic pain and to examine gender and age differences in this population. The gate control theory provided the framework for the study. The Pain Coping Questionnaire was used to measure coping strategies in a convenience sample of 44 children and adolescents recruited from pain clinics and online pain support groups. Descriptive statistics indicated that active coping was used most often, and emotion-focused coping was used least often. Analyses of variance indicated that age was positively related with cognitive distraction, that male participants used problem-solving more often than female participants, and that female participants sought out social support and used internalizing/catastrophizing more often that male participants. Findings may be used to improve assessment and management of chronic pain by providing mentalhealth professionals and doctors with a better understanding of African American children and adolescents’ coping strategies.

► This thesis traces the history of mentalhealth over various populations, with a strong emphasis in the Asian and Asian American communities. This thesis explores…
(more)

▼ This thesis traces the history of mentalhealth over various populations, with a strong emphasis in the Asian and Asian American communities. This thesis explores how mentalhealth services have changed over time. In most countries, mentalhealth awareness has been increasing, which has been making a positive impact on its health care system. It is interesting to study how the quantity and quality of health services have also increased. By looking at studies on the differences of cultural impact, taboo, and generational disparities, a greater understanding can be made on the health needs of the Asian population. This thesis finds that amidst generational differences, Asian Americans are still strongly influenced by their native culture. By educating and understanding the cultural differences between patients and practitioners, a more efficient model for mentalhealth care services can be created.

► BACKGROUND: Poor mentalhealth and the varying stressors that provoke psychological disturbance are considerable issues that plague the United States young adult population. Within the…
(more)

▼ BACKGROUND: Poor mentalhealth and the varying stressors that provoke psychological disturbance are considerable issues that plague the United States young adult population. Within the collegiate student-athlete cohort, where athletes are subjected to unique pressures placed on them secondary to performance demands, significant injury such as an ACL tear requiring surgical reconstruction and a rigorous rehabilitation course remains a major contributor to psychological and physical disruption. Females in particular may be at higher risk of psychological instability due to hormonal and personality factors, increased injury rates, and gender bias that still exists in the collegiate sports world.
LITERATURE REVIEW FINDINGS: Despite recognition of the mentalhealth sequelae of injury in this cohort, sports medicine personnel report discomfort in approaching emotional difficulties and mentoring athletes on the utilization of psychological skills. In conjunction, referral to sports psychologists remains low. The use of a universal self-report survey can help athletes and sports medicine providers acknowledge the psychological impact of injury and take proactive action to provide the athlete with the necessary psychological support needed to fully recover and return to play.
PROPOSED PROJECT: The goal of this cross-sectional study is to use a previously validated psychometric tool to assess and compare differences in acute psychological response to ACL tear in male and female collegiate soccer players. If there is a consistent gender disparity observed based on survey scores, sports medicine specialists could develop heightened awareness toward a specific gender that is at high-risk for psychological instability following injury and provide immediate psychological intervention if an event occurs.
CONCLUSIONS: The use of a psychometric survey to assess mentalhealth in the collegiate athlete population should be standard practice. If used correctly, the tool has the ability to assess injury response and the need for psychological intervention for all athletes suffering from chronic injuries. The benefits are widespread among all parties of the sports medicine team and the end result is increased stability and mental well-being within the athletic environment.
SIGNIFICANCE: The clinical significance of the study extends beyond identifying gender and demographic risk factors and aims to stress the importance of recognizing psychological distress following injury and the necessity of appropriate psychological intervention in a large population of student-athletes across the country.

► This dissertation explored several internal and external factors in relation to psychiatric readmissions. Internal factors are directly related to the individual i.e., demographic information,…
(more)

▼ This dissertation explored several internal and external factors in relation to psychiatric readmissions. Internal factors are directly related to the individual i.e., demographic information, diagnosis, admission history and status. External factors are factors outside of the individuals control i.e., length of hospital stay and reimbursement processes. The goal of the study was to explore the impact of multiple factors in relation to the phenomenon of psychiatric readmissions. Dynamic Systems Theory (1994) was used as a theoretical foundation to understand the complexities associated with psychiatric readmissions. The study utilized state archival data provided by the Maryland Health Services Cost Review Commission; an agency charged with collecting statewide hospital data on hospital admissions. A quasi experimental study was conducted using a logistic regression design to answer the research question: When taken together do age, sex, ethnicity, diagnosis, insurance type, admission status and length of stay predict psychiatric readmission? This researcher predicted that the null hypothesis will be rejected. The sample included a large state-wide data set of over 130,000 individuals who fell under the criteria of being over the age of 18 when readmitted for psychiatric care in Maryland in 2015. The research methodology includes a logistic regression research design, exploring multiple factors, simultaneously, that impact psychiatric readmissions. The results of the study indicate that length of stay is the most important factor impacting psychiatric readmissions. The second most important factor associated with psychiatric readmission, is a psychiatric readmission within 30 days. Medicare and Medicaid were also found to be significant factors associated with psychiatric readmission. Additionally, affective disorders were found to be the primary diagnosis associated with psychiatric readmissions. Lastly, individuals at greatest risk for psychiatric readmissions are between the age of 18-39, are non-Hispanic, are enrolled in Medicare, most likely to be disabled, are diagnosed with an affective disorder and have had a previous psychiatric readmission.

► It has been recommended that Irish mentalhealth services adopt a recovery perspective (Department of Health and Children 2006). However there is no unified theory…
(more)

▼ It has been recommended that Irish mentalhealth services adopt a recovery perspective (Department of Health and Children 2006). However there is no unified theory of recovery capable of guiding services (Craig 2008). The aim of this study was to develop a coherent theory of recovering from mentalhealth problems. This was the first grounded theory study of recovery in Ireland.
The study methodology was guided by critical realism and classical grounded theory. The study was based on open-ended individual interviews with 32 volunteers who had experienced mentalhealth problems more than once over a period of two years and considered themselves in improvement. Most participants (n=23) were recruited via mentalhealth services, and nine via peer support or community groups.
The core category of recovery was labelled as ‘re-connecting with life‘. It had three interactive subcategories: 1) reconnecting with self through accepting the self as a worthy human being capable of positive change; 2) reconnecting self with others through empathic, accepting, and validating connection; 3) reconnecting self with others and time, through establishing coherence of one’s past and actively shaping and executing one’s present and future. Synchronising self and others in time was reported as an important goal and tool of reconnecting with life, and was achieved through talking, understanding, empathy and giving back.
This study shows that through non-judgemental and accepting connection with peers or service-providers persons can relearn to understand and value themselves and others, come to terms with the past, and plan and execute their present and future. This study provides evidence that through a dynamic connection with self, others and time one can regain meaningfulness of one’s life, which was found to be crucial for physical and mentalhealth. Implications for mentalhealth policy, practice, education and research are provided.
Advisors/Committee Members: Stevenson, Chris.

► Inadequate public health resources coupled with a chronically overburdened health system leave a large proportion of South Africans unable to access mentalhealth care. Low-income…
(more)

▼ Inadequate public health resources coupled with a chronically overburdened health system leave a large proportion of South Africans unable to access mentalhealth care. Low-income pregnant women with common mental disorders (CMDs) are arguably more vulnerable to falling through the treatment gap, given the low rates of detection during pregnancy and the numerous additional barriers to care. The direct and indirect financial and personal costs associated with perinatal mental illness are substantial, while the high prevalence rates of perinatal CMDs make this an area in need of urgent attention. Integrating task shifting approaches into perinatal primary health care services is a promising solution. The first chapter introduces the thesis, providing context to the studies that are presented in later chapters and an overview of the research questions that informed them. The second chapter constitutes a systematic review of the literature relevant to the studies. Chapters 3 to 6 report on the findings of the studies, briefly described in the abstract below. The prevalence and risk factors associated with perinatal psychological distress - a plausible precursor for common mental disorders (CMDs) - are not widely understood in under-resourced settings. The first study (Chapter 3) investigates the prevalence and predictors of psychological distress in the antenatal period. Data were collected from 664 pregnant women who reported for antenatal care to any one of 11 Midwife and Obstetric Units (MOU) across the greater Cape Town area. Psychological distress was measured using the Symptom Response Questionnaire (SRQ-20; cut-off value of 7/8), while data pertaining to risk factors were collected via a demographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Multidimensional Scale of Perceived Social Support (MSPSS). The prevalence of antenatal psychological distress was 38.6%. Risk factors included low socio-economic status (SES) (OR = 1.45, 95% CI: 1.24-1.68); recent physical abuse and/or rape (OR = 1.94, 95% CI: 1.57-2.40); complications during a previous delivery (OR = 1.18, 95% CI: 1.01-1.38); having given birth before (OR = 1.61, 95% CI: 1.21-2.14). The high prevalence rate of psychological distress is consistent with those found in other South African studies of perinatal CMDs. Appropriate, context-specific, and effective interventions are better served by investigating a broader range of symptoms associated with perinatal CMDs in these settings. The second study (Chapter 4) examines the mentalhealth literacy (MHL) of pregnant women, including their perceptions of the causes of mental illness during pregnancy and best treatment approaches. Understanding the factors that represent barriers to accessing care is important to the development of accessible interventions. Globally, low levels of mentalhealth literacy have often been identified as one such treatment barrier. However, little is known about how pregnant women perceive and understand mental illness during this…
Advisors/Committee Members: Sorsdahl, Katherine R (advisor), Stein, Dan J (advisor), Naledi, Tracey (advisor).

Spedding, M. F. (2017). Perinatal psychological distress in the South African context: The road to task shifting evidence based interventions. (Thesis). University of Cape Town. Retrieved from http://hdl.handle.net/11427/25454

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Spedding, Maxine F. “Perinatal psychological distress in the South African context: The road to task shifting evidence based interventions.” 2017. Thesis, University of Cape Town. Accessed September 15, 2019.
http://hdl.handle.net/11427/25454.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Spedding MF. Perinatal psychological distress in the South African context: The road to task shifting evidence based interventions. [Thesis]. University of Cape Town; 2017. Available from: http://hdl.handle.net/11427/25454

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

► Methamphetamine users may suffer from a range of co-morbid psychiatric disorders. Predictors of treatment outcome in substance dependence may include both such co-morbidity and readiness…
(more)

▼ Methamphetamine users may suffer from a range of co-morbid psychiatric disorders. Predictors of treatment outcome in substance dependence may include both such co-morbidity and readiness for change. The nature of the relationship between psychiatric co-morbidity and readiness for change has not been systematically studied. Therefore, this study aimed to assess the prevalence and patterns of psychiatric disorders in individuals dependent on methamphetamine; determine whether there is a relationship between such co-morbidity and readiness for change; and identify factors associated with readiness for change in this group.
Advisors/Committee Members: Stein, Dan J (advisor), Wilson, Don (advisor).

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

West Virginia University

16.
Vohra, Rini.
Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey.

► The main objective of the study was to examine health care disparities for children with autism spectrum disorders utilizing two studies.;Study 1. A cross sectional…
(more)

▼ The main objective of the study was to examine health care disparities for children with autism spectrum disorders utilizing two studies.;Study 1. A cross sectional study was conducted using the 2009-2010 National Survey of Children with Special Health Care Needs (N = 18,702). Chi-square analyses and logistic regressions were performed to examine the likelihood of reporting problems with access to services, quality of care, and family impact and compared across ASD, DD (cerebral palsy, down syndrome, developmental delay, or mental retardation), MHC (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression) and DD & MHC (those who had both DD and MHC) group, after adjusting for socio-demographics, number of special children in the household, child's functional ability, and presence of a physical condition. All analyses were adjusted for complex survey design.;Results: Access to Services: ASD caregivers were significantly more likely to have difficulty using services as compared to DD, MHC, and DD & MHC caregivers. ASD caregivers were more likely to report inadequate insurance coverage as compared to MHC, and DD but not DD & MHC caregivers. Quality of care: ASD caregivers were more likely to report lack of shared decision making, as compared to DD, MHC, and DD & MHC caregivers. ASD caregivers were also more dissatisfied with care coordination as compared to DD, MHC and DD & MHC caregivers. Family Impact: ASD caregivers were more likely to have financial burden as compared to DD and MHC, but not DD & MHC caregivers. ASD caregivers were also found to be more likely to have employment burden, as compared to DD, MHC, and DD & MHC caregivers. Time-related burden was also significantly different between the four groups, where ASD caregivers were more likely to have time-related burden as compared to MHC, and DD & MHC caregivers.;Conclusion: ASD caregivers differ significantly in their report of difficulty using services, adequacy of insurance coverage, shared decision making, care coordination, and family impact as compared to DD and MHC caregivers.;Study 2. Data on caregivers of children with ASD was drawn from 2009-2010 National Survey for Children with Special Health Care Needs (N = 3,025) with a representative sample from each state. Two state health policy (Medicaid Income Eligibility & autism mandate as a proxy measure of states' autism health care initiative) and two state health care workforce (Child to Pediatrician Ratio & Special Education Teachers per 1,000 Special Education Students) estimates were taken from publicly available sources. Multilevel regressions were used to model the associations between state contextual characteristics and dependent outcome measures, controlling for state median household income, percentage of children in poverty, percentage of children with developmental disorders, child, and caregiver level characteristics.;Results: The caregivers of children with ASD reported difficulty using services (54.5%), difficulty getting referrals (27.7%), lack of…
Advisors/Committee Members: Suresh Madhavan, Usha Sambamoorthi, Claire St. Peter.

Vohra, R. (2013). Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey. (Thesis). West Virginia University. Retrieved from https://researchrepository.wvu.edu/etd/191

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Vohra, Rini. “Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey.” 2013. Thesis, West Virginia University. Accessed September 15, 2019.
https://researchrepository.wvu.edu/etd/191.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Vohra, Rini. “Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey.” 2013. Web. 15 Sep 2019.

Vancouver:

Vohra R. Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey. [Internet] [Thesis]. West Virginia University; 2013. [cited 2019 Sep 15].
Available from: https://researchrepository.wvu.edu/etd/191.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Vohra R. Access to Services, Quality of Care, and Family Impact for Caregivers of Children with Autism Spectrum Disorders: A National Perspective Using 2009-2010 Children with Special Health Care Needs (CSHCN) Survey. [Thesis]. West Virginia University; 2013. Available from: https://researchrepository.wvu.edu/etd/191

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Columbia University

17.
Kapadia, Amy.
Race-ethnic discrimination, Major Depression, and Alcohol Use Disorder among US-born and immigrant minorities.

► This dissertation used data from The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to expand upon what is known about the relationship between…
(more)

▼ This dissertation used data from The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to expand upon what is known about the relationship between perceived race-ethnic discrimination and mentalhealth outcomes while uniquely comparing race-ethnic groups across both US-born and immigrant populations. Specifically, two DMS-IV disorders, Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) were examined as outcomes. The dissertation sample (n = 13,914) was drawn from Wave II of the data and included Black, Hispanic, and Asian respondents. The first question addresses the associations between perceived race-ethnic discrimination and the mentalhealth disorders. Question two examined the risk and protective roles of four cultural-social factors for both disorders as well as their moderating roles in the race-ethnic discrimination-mentalhealth relationship. Prevalence analysis revealed that almost 20% of minorities experienced past-year race-ethnic discrimination. Results from logistic regressions found that minorities who experienced race-ethnic discrimination were about two times as likely to have MDD or AUD than minorities who did not experience race-ethnic discrimination (ORs = 2.0 and 1.8, respectively). Comparisons across sub-populations of US-born, immigrant, Black, Hispanic, Asian, and gender groups found a few differences in terms of the effects of discrimination and mentalhealth disorders. While moderation analyses failed to yield significant results for race-ethnic discrimination, the four cultural and social factors appeared to moderate the relationship between MDD and AUD, respectively. Findings corroborate and expand upon previous work demonstrating a consistent, strong, and positive relationship between perceived race-ethnic discrimination and mentalhealth outcomes across minority populations yielding practice and policy implications. Further research is needed to examine causal associations using longitudinal data as well as to elucidate upon the role of protective and risk factors given cultural and community-based factors.

► Background: South Korea’s cultural tendency to emphasize social conformity makes South Koreans more vulnerable to social stigmas and to psychosocial problems. People who have body…
(more)

▼ Background: South Korea’s cultural tendency to
emphasize social conformity makes South Koreans more vulnerable to
social stigmas and to psychosocial problems. People who have body
sizes that do not conform to Korean social norms might be
vulnerable to mentalhealth problems. This study intends to examine
the associations between perceived body image and mentalhealth
outcomes among South Korean adults. Methods: Secondary data
analyses were conducted using the Korea National Health and
Nutrition Examination Survey, 2013-2015 (KNHANES-VI). Persons of
ages 19 and older were included in the analyses. We conducted a
series of weighted logistic regressions to investigate the
associations between mentalhealth outcomes (i.e., lifetime
depression diagnosis, high stress level, suicide ideation and
perceived health status) and body image (i.e., perceived body
image, body mass index (BMI), and body image distortion). Results:
Compared to people who perceived their bodies to be ‘average’,
people who perceived themselves to be ‘obese’ had higher odds of
having been diagnosed with depression during their lifetime (OR:
1.40, 95%CI 1.13-1.72), high stress level (OR: 1.32, 95%CI
1.20-1.46), and suicidal ideation (OR: 1.53, 95%CI 1.28-1.84). The
‘obese’ group also had 0.57 (OR: 0.57, 95%CI 0.52-0.63) lower odds
of perceiving themselves to be healthy. In additional sensitivity
analysis, similar results were obtained when logistic regressions
were run using all four BMI groups. The ‘obese’ group had higher
odds of having high stress level (OR: 1.29 95%CI 1.13-1.47), and
lower odds of perceiving themselves to be healthy (OR: 0.58 95%CI
0.51-0.67), compared with the ‘average’ BMI group. Those with
positive distortion of body image were less likely to have high
stress levels (OR: 0.69 95%CI 0.57-0.84), suicidal ideation (OR:
0.69 95%CI 0.49-0.97) and more likely to perceives themselves to be
‘healthy’ (OR: 2.08 95%CI 1.68-2.58). Conclusions: Given the
observed associations between mentalhealth and body image,
especially that of positive distortion of body image, it will be
helpful for future weight control and body image interventions to
address body acceptance, self-esteem, and mentalhealth. Future
research should focus on identifying risk factors, protective
factors, and other social and cultural factors that lead to body
image distortion.
Advisors/Committee Members: Operario, Don (Advisor), Williams, David (Reader).

While existing research suggests that caregivers contribute to the onset and maintenance of adolescent substance use, research also posits that caregivers are negatively affected by…
(more)

▼

While existing research suggests that caregivers contribute to the onset and maintenance of adolescent substance use, research also posits that caregivers are negatively affected by adolescent substance use. However, caregivers' experiences of adolescent substance use is the subject of little academic research, and it remains poorly understood. This study offers important empirical insights that address this significant gap in the literature. The purpose of this study is to understand how caregivers perceive and describe their experience with their adolescent's substance use. To gain a deeper understanding of the reciprocal relationship between caregivers and adolescent substance use issues, this study uses a phenomenological, qualitative research approach to examine caregivers' experiences of their adolescent's substance use issues. The guiding theoretical framework is family systems theory (FST; Bowen, 1974). Additionally, the study employed a Community-Based Participatory Research (CBPR) approach by actively involving community members, organizational representatives, and researchers in the research process (Israel, Schulz, Parker, & Becker, 1998). Data were collected through in-depth, qualitative interviews with 20 caregivers of adolescents with substance use issues. Data analyses resulted in 6 core themes: 1) Discovering and making meaning of the substance use, 2) A complex issue, 3) A systemic issue, 4) Process of treatment, 5) Parental efficacy, and 6) The silver lining. Results illustrate how parents discovered and made meaning of their adolescent's substance use. Findings explain how adolescent substance use is a complex and systemic issue, often disrupting the entire family system, leaving caregivers questioning their parental efficacy and negotiating the caregiver-child relationship. The results highlight the process of treatment, transformation, and the growth that took place at the individual and family level. Several implications for future research and clinical practice were identified. The study highlights the need to further examine the reciprocal relationship between caregivers and adolescent substance use. Results can also speak to how family-focused treatment of adolescent substance use may be adapted to meet the needs of this unique population. More specific suggestions for future research and for marriage and family therapists working with families experiencing adolescent substance use issues are provided.

A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy.

This dissertation seeks to increase understanding about why older African Americans have equal or lower rates of mental illness than whites; despite the general tendency…
(more)

▼

This dissertation seeks to increase understanding about why older African Americans have equal or lower rates of mental illness
than whites; despite the general tendency that disadvantaged individuals have worse mentalhealth than advantaged individuals. To explain
the unexpected finding from a methodological standpoint, this study uses the 2008 and 2012 Waves of the Health and Retirement Study and
examines racial differences in the factor structures of mental illness focusing on symptoms included in the CES-D (Center for
Epidemiologic Studies Depression) and the BAI (Beck Anxiety Inventory). To understand the implications of these racial differences in the
stress process, this study also examines how discrimination, as a type of stressor, manifests into different mentalhealth outcomes
(somatic or mood-based symptoms) between older African Americans and whites. The analysis employs structural equation modeling and finds
that modeling CES-D and BAI items as mood-based and somatic constructs of general distress has better model fit than modeling these items
than as separate constructs of depression and anxiety (Chapter 2). In regard to racial differences in the factor structure of these
models, the analysis finds that the factor structure of the somatic model differs between the racial groups whereas the factor structure
of the mood-based model does not differ. When examining how discrimination manifests into different mentalhealth outcomes, the analysis
shows that discrimination is related to increased mood-based symptoms among whites and unrelated to mood-based symptoms among African
Americans (Chapter 3). Additionally, everyday discrimination and lifetime discrimination are related to increased somatic symptoms among
whites. Among African Americans, physical disability and financial status based discrimination are related to increased somatic symptoms,
and lifetime discrimination and ancestry-based discrimination are related to decreased somatic symptoms. The findings from this
dissertation suggest that current measures of mental illness (e.g., CES-D, BAI, etc.) may not measure the same constructs across racial
groups and that modeling mental illness as mood-based and somatic constructs may give better insights into the prevalence of mental
illness among older adults. Further, this study sheds light on the potential effects of discrimination on an alternative and more
culturally specific expression of mental illness symptoms (somatic symptoms). This study also extends the literature on discrimination and
mentalhealth by illustrating how different forms of discrimination impact different mentalhealth outcomes.

A Dissertation submitted to the Department of Sociology in partial fulfillment of the requirements
for the degree of Doctor of Philosophy.

Vaghela, P. (2016). College of Social Sciences and Public Policy Racial Differences in the Manifestation of Mental Illness Among Older
Adults. (Doctoral Dissertation). Florida State University. Retrieved from http://purl.flvc.org/fsu/fd/FSU_2016SP_Vaghela_fsu_0071E_13115 ;

Chicago Manual of Style (16th Edition):

Vaghela, Preeti. “College of Social Sciences and Public Policy Racial Differences in the Manifestation of Mental Illness Among Older
Adults.” 2016. Doctoral Dissertation, Florida State University. Accessed September 15, 2019.
http://purl.flvc.org/fsu/fd/FSU_2016SP_Vaghela_fsu_0071E_13115 ;.

MLA Handbook (7th Edition):

Vaghela, Preeti. “College of Social Sciences and Public Policy Racial Differences in the Manifestation of Mental Illness Among Older
Adults.” 2016. Web. 15 Sep 2019.

Vancouver:

Vaghela P. College of Social Sciences and Public Policy Racial Differences in the Manifestation of Mental Illness Among Older
Adults. [Internet] [Doctoral dissertation]. Florida State University; 2016. [cited 2019 Sep 15].
Available from: http://purl.flvc.org/fsu/fd/FSU_2016SP_Vaghela_fsu_0071E_13115 ;.

Council of Science Editors:

Vaghela P. College of Social Sciences and Public Policy Racial Differences in the Manifestation of Mental Illness Among Older
Adults. [Doctoral Dissertation]. Florida State University; 2016. Available from: http://purl.flvc.org/fsu/fd/FSU_2016SP_Vaghela_fsu_0071E_13115 ;

Florida State University

21.
Beerse, Megan E.Is There a Biofeedback Response to Art Therapy?: A Multidisciplinary Approach for Reducing Anxiety and Stress in College Students.

Although the field of art therapy has made enormous headway in quantitative research within the last ten years, there are still significant gaps that need…
(more)

▼

Although the field of art therapy has made enormous headway in quantitative research within the last ten years, there are still significant gaps that need explored. Most quantitative research on art therapy and stress is organized in either pretest-posttest single sessions or multi-week, rigorous art therapy interventions. Researchers have failed to address an intervention strategy that meets in the middle, a strategy that emphasizes mentalhealth as a habitual practice. Mindfulness and art therapy independently demonstrate efficacy in reducing stress and symptoms of anxiety with higher-education students, but again, these interventions require a substantial time commitment that many students will not make. To address the mentalhealth crisis on college campuses, this study evaluated the feasibility of a minimal contact, technology-assisted Mindfulness-Based Art Therapy (MBAT) intervention for higher-level education students over the course of ten weeks. The experimental MBAT group was compared to a neutral clay task (NCT) comparison group. Participants of the MBAT condition were provided a variety of yoga videos and meditation clips, which have been uploaded as supplementary files associated with this manuscript. These supplementary files include: MBAT Week 2 Meditation, MBAT Week 3 Yoga Sequence, MBAT Week 4 Meditation, MBAT Week 5 Meditation, MBAT Week 6 Yoga Sequence, MBAT Week 7 Meditation, MBAT Week 8 Yoga Sequence, and MBAT Week 9 Meditation. All meditations are audio files adapted by Dr. Sean Sullivan from Limbix; the researcher, Megan Beerse, produced all yoga sequence videos. Self-report outcomes were collected on perceived stress and levels of generalized anxiety. Salivary cortisol sampling was conducted on the first and last weeks of the study to determine any presence of a physiological impact on participants. Fifteen participants were recruited and nine maintained participation through all 10 weeks. Reduced symptoms of generalized anxiety were observed in the MBAT condition but not the NCT condition. MBAT participants’ salivary cortisol concentrations significantly decreased pretest to posttest on Week 10 but not on the first week, while the NCT participants experienced the opposite. Further data is needed, but results suggest the possibility of a biofeedback response to art therapy as well as anxiety-reducing benefits from practicing mindfulness-based art therapy directives in the form of a minimal contact, technology-assisted approach.

A Thesis submitted to the Department of Art Education in partial fulfillment of the requirements for the degree of Master of Science.

Beerse, M. E. (2018). Is There a Biofeedback Response to Art Therapy?: A Multidisciplinary Approach for Reducing Anxiety and Stress in College Students. (Masters Thesis). Florida State University. Retrieved from http://purl.flvc.org/fsu/fd/2018_Su_Beerse_fsu_0071N_14796_comp ;

Beerse ME. Is There a Biofeedback Response to Art Therapy?: A Multidisciplinary Approach for Reducing Anxiety and Stress in College Students. [Internet] [Masters thesis]. Florida State University; 2018. [cited 2019 Sep 15].
Available from: http://purl.flvc.org/fsu/fd/2018_Su_Beerse_fsu_0071N_14796_comp ;.

Council of Science Editors:

Beerse ME. Is There a Biofeedback Response to Art Therapy?: A Multidisciplinary Approach for Reducing Anxiety and Stress in College Students. [Masters Thesis]. Florida State University; 2018. Available from: http://purl.flvc.org/fsu/fd/2018_Su_Beerse_fsu_0071N_14796_comp ;

University of Zambia

22.
Ngoma, Misozi.
A Study on prevelance and factors associated with high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka
.

► The problem of readmissions of the mentally ill adults is widespread and it has continued over many years. It occurs in the people of all…
(more)

▼ The problem of readmissions of the mentally ill adults is widespread and it has continued over many years. It occurs in the people of all racial background and social economic groups.Chainama Hills Hospital in Zambia has not been spared from this phenomenon. Readmission of the mentally ill adults has been associated with adverse outcomes on the clients, their families
and the readmitting institution. Unfortunately very little in terms of research has been done in Zambia on this topic. This has necessitated this study to be conducted. The purpose of this study
was to determine the prevalence and factors associated with readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka Zambia. A cross Sectional design study was conducted. Qualitative and Quantitative methods were used to collect date. Two hundred and thirty (230) and 0ne hundred and fifty (150) of relatives to patients(care givers) and patients
respectively who were readmitted and who came for review to Chainama Hills Hospital were interviewed using a structured questionnaire. The participants were selected consecutively as they came for readmission and review. To complement data from the survey, two focus group
discussions (comprising 8 participants for group 1 and 10 participants for group 2) was
conducted. The sample provided 95% power of confidence and p- value of 0.05.Quantitative data was analyzed using SPSS version 17.0. The prevalence was established to be 19.72%.The study finding revealed that beer intake and bad socio-cultural practices were significantly associated with readmission of the mentally ill adults. The study further found that factors such as sex of being male, age of being more than 35years , education, employment, being single, distance of12km and more from nearest mentalhealth facility, taking more than 2hours to reach the nearest mentalhealth facility, diagnosis of schizophrenia, smoking, type of substance smoked, not taking drugs according to prescribed frequency and overall treatment compliance showed no association with readmission of the mentally ill adults after multivariate analysis was done.
However in other similar studies these same factors were found to be statistically significance. The study findings accepts the alternative hypothesis which states that there is a relationship between demographic characteristics, lack of compliance to treatment and socio-cultural mpractices and high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in
Lusaka. In conclusion beer drinking and bad socio-cultural practices were associated with high rates of readmission of the mentally ill adults at Chainama Hills Hospital.It was recommended that mass education of the communities be embarked on to discourage bad social practices by communities and the patients so as to reduce relapses and rehospitalisation.

Ngoma, M. (2011). A Study on prevelance and factors associated with high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka
. (Thesis). University of Zambia. Retrieved from http://hdl.handle.net/123456789/901

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Ngoma, Misozi. “A Study on prevelance and factors associated with high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka
.” 2011. Thesis, University of Zambia. Accessed September 15, 2019.
http://hdl.handle.net/123456789/901.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Ngoma M. A Study on prevelance and factors associated with high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka
. [Internet] [Thesis]. University of Zambia; 2011. [cited 2019 Sep 15].
Available from: http://hdl.handle.net/123456789/901.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Ngoma M. A Study on prevelance and factors associated with high rates of readmissions of the mentally ill adults at Chainama Hills Hospital in Lusaka
. [Thesis]. University of Zambia; 2011. Available from: http://hdl.handle.net/123456789/901

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

► The full experience of mental illness cannot be described in isolation from the context in which one lives, yet the internal physical manifestation of symptoms…
(more)

▼ The full experience of mental illness cannot be described in isolation from the context in which one lives, yet the internal physical manifestation of symptoms has been the focus of treatment in western cultures. The “recovery” paradigm is emerging as best-practice philosophy for mentalhealth practice and represents a significant departure from existing standards thereby challenging mentalhealth organizations to re-negotiate their relationship with the dominant bio-medical model. Despite the growing acceptance of recovery philosophy, literature exploring large-scale recovery-oriented organizational change is sparse. The purpose of this research was twofold; 1) to outline the steps taken by change agents within an organization embarking on recovery organizational change, and 2) to understand the experience, including successes and challenges associated with change. The qualitative data obtained from interviewing seventeen participants revealed the impact of organizational contextual factors, leadership and communication on recovery organizational change. Further, the data exposed the complexity of challenging preconceptions and practice when trying to adopt recovery approaches. The findings may guide other community based mentalhealth organizations in their recovery journey.

▼ The estimated annual economic burden of
serious mental illness is $317 billion, excluding costs associated
with comorbid conditions, incarceration, homelessness, and early
mortality. This sum is equivalent to about $1,000/year for every
man, woman, and child in the United States (Kessler et al., 2008).
A critical need exists for a thorough examination of public mentalhealth care spending. This information is important so that policy
makers, foundations, and community agencies can make informed and
rational planning decisions regarding the optimal mix of services
to provide. It is commonly believed that the decrease in public
funding for mentalhealth has had the effect of focusing money on
chronic illnesses to the exclusion of funding for prevention, early
intervention, or treatment of acute disorders.
The purpose of this descriptive study was to
document how public dollars have been spent on mentalhealth by
examining what problems and populations are being addressed and by
whom. In addition, the study documented the distribution of county
spending by source, identified the top service providers, and
ascertained spending priorities amongst the provider agencies.
Finally, this research addressed the implications of those spending
patterns, likely future outcomes, and offered policy
recommendations. It was necessary to review data
from the individual agencies which received and distributed public
funds. The data were gathered in Hamilton County, OH, based on the
largest providers given the difficulty of state or multi-county
analysis. The initial step was obtaining budgets from the Hamilton
County MentalHealth Recovery and Services Board for fiscal year
2010 (FY 2010) and creating a report which tracked the flow of
funds from their sources to the agencies that delivered services.
Then, funder expenditures and agency services were integrated and
findings were discussed by local mentalhealth experts via
individual interviews. Results showed that ten
agencies were responsible for approximately 82% of public mentalhealth spending in Hamilton County. Federal funding represented
approximately 52% of total funding, while local tax support
contributed 36% and state funding was less than 12%. Total spending
on prevention services accounted for only 2% of the total mentalhealth budget. Chronic care was by far the largest expenditure in
the county. The top ten agencies spent an average of $10,640 per
chronically ill client in federal, state, and local funds on mentalhealth services in FY 2010. Conversely, less than $100 was spent
per client on prevention services. Key informant
interviews provided insight into why little systemic attention is
paid to prevention. While 100% of agency leaders agreed that
prevention is important and critical in stemming the growing unmet
mentalhealth treatment need, there were commonly cited barriers to
shifting priorities, centering on the difficulty of measuring
impact. Preventing an even greater percentage of unmet need in our
communities requires a…
Advisors/Committee Members: Howe, Steven (Committee Chair).

▼ Ongoing global crises impact negatively on human health. International comparison studies
may improve health promotion. A community psychology, appreciative inquiry was
conducted into local staff perceptions of selected child and adolescent mentalhealth
interventions in the Kent and Zululand regions of the United Kingdom and South
Africa respectively. The Kent findings, supported by a quasi-experimental
investigation, indicated that intervention was beneficial, the mentalhealth practitioner role
had value and additional mentalhealth practitioners should be employed. The Zululand
findings, complemented by a single client case study, suggested that intervention provided a
valuable people focused programme, and that additional emphasis should be placed on
promoting the intervention, its structure and staffing. Evaluative comparisons thus illustrated
the differential effectiveness of the respective interventions. The Kent service could learn
from the way in which the Zululand intervention was people orientated and the Zululand
programme could learn from the way in which the Kent intervention was structured and
organized. Findings highlighted the ongoing need to evaluate existing models of community
psychology, create new models, and the temporal and contextual nature of any such models.
Advisors/Committee Members: Thwala, J.D (advisor), Ngcobo, H.S.B (advisor).

Edwards, D. J. (2012). A comparative evaluation of child and adolescent mental health interventions in the United Kingdom and South Africa
. (Thesis). University of Zululand. Retrieved from http://hdl.handle.net/10530/1241

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Edwards, David John. “A comparative evaluation of child and adolescent mental health interventions in the United Kingdom and South Africa
.” 2012. Thesis, University of Zululand. Accessed September 15, 2019.
http://hdl.handle.net/10530/1241.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Edwards, David John. “A comparative evaluation of child and adolescent mental health interventions in the United Kingdom and South Africa
.” 2012. Web. 15 Sep 2019.

Vancouver:

Edwards DJ. A comparative evaluation of child and adolescent mental health interventions in the United Kingdom and South Africa
. [Internet] [Thesis]. University of Zululand; 2012. [cited 2019 Sep 15].
Available from: http://hdl.handle.net/10530/1241.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Edwards DJ. A comparative evaluation of child and adolescent mental health interventions in the United Kingdom and South Africa
. [Thesis]. University of Zululand; 2012. Available from: http://hdl.handle.net/10530/1241

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

California State University – Sacramento

26.
Martini, Danielle Olivia.
Turning Point Community Programs integrated service agency program evaluation.

► The purpose of this project was to address the effectiveness of Turning Point Community Programs (TPCP) Integrated Service Agency (ISA) in providing mentalhealth services.…
(more)

▼ The purpose of this project was to address the effectiveness of Turning Point Community Programs (TPCP) Integrated Service Agency (ISA) in providing mentalhealth services. A literature review was conducted to assess the need and challenges for outcomes of Wellness and Recovery Oriented services. As human service organizations compete for available dollars to provide mentalhealth services to those with severe and persistent mental illness, it is imperative to demonstrate the effectiveness of services. This researcher analyzed secondary data, Level of Care Utilization System and Milestones of Recovery Scale scores, obtained from TPCP ISA for all members served for fiscal year 2008/2009. The research supported that continuous Recovery based mentalhealth services do positively impact TPCP ISA mentalhealth consumers.
Advisors/Committee Members: Navari, Sylvia.

► Childhood and adolescent mentalhealth is a major public health concern. Childhood behavioral problems and low self-esteem can predispose children to future depression. Mentalhealth…
(more)

▼ Childhood and adolescent mentalhealth is a major
public health concern. Childhood behavioral problems and low
self-esteem can predispose children to future depression. Mentalhealth issues often emerge in adolescence making examination of
potential early modifiable risk factors for these three mentalhealth indicators crucial. Potential risk factors for mentalhealth
issues often reflect findings from Western settings where
confounding by low socioeconomic position may occur, making it
difficult to establish causation. Evidence from a setting with a
different confounding structure, such as Hong Kong, is valuable in
elucidating whether previous findings are contextually specific or
biologically based.
This thesis utilized a large (n=8,327)
population-representative Chinese birth cohort, Hong Kong’s
“Children of 1997,” from a developed non-Western setting with a
different confounding structure, to 1) examine how behavioral
problems and self-esteem may identify children with a
predisposition to depressive symptoms and 2) examine the
associations of early modifiable risk factors, including migration
status, secondhand smoke (SHS) exposure, mode of delivery and type
of child care (informal care such as in-home employed help or
grandparent care), with these three mentalhealth indicators:
behavioral problems, self-esteem and depressive symptoms.
This
research study utilized parent-reported Rutter scores for
behavioral and emotional problems at ~7 and ~11 years,
self-reported Culture-Free Self-Esteem Inventories scores at ~11
years and the Patient Health Questionnaire-9 (PHQ-9) depressive
symptom score at ~13 years to assess childhood and adolescent
mentalhealth. First, partitional clustering was used to generate
homogeneous trajectories between ~7 and ~11 years for child
behavior and changes in low self-esteem between ~10 and ~12 years;
multivariable linear regression was then used to estimate their
adjusted associations with subsequent PHQ-9 score. Second,
multivariable linear regression was used to examine the adjusted
associations of parental migration status, SHS exposure, mode of
delivery and type of child care with the three mentalhealth
outcomes.
This researcher found that in a graded manner, Rutter
score trajectories (stable low, declining and rising) and
self-esteem changes (stable high, rising and declining) were
associated with more depressive symptoms. Parental migration was
associated with better behavior at ~7 and ~11 years, but prenatal
SHS exposure was associated with more behavioral problems. Mode of
delivery was not associated with the three mentalhealth outcomes.
Meanwhile, in-home employed help was only associated with lower
self-esteem and more depressive symptoms, although care by
grandparents was associated with fewer behavioral problems.
To
conclude, in this population-representative Hong Kong birth cohort,
sustained behavioral problems and low self-esteem were strongly
associated with depressive symptoms, potentially highlighting the
need for earlier identification of and…

► The aims of the study are to explore the “lived experience” of re-engaging with life after attempted suicide, and provide deeper insight into this important…
(more)

▼ The aims of the study are to explore the “lived experience” of re-engaging with life after attempted suicide, and provide deeper insight into this important phenomenon in order to help others in similar circumstances. The research question that informed the study was “What is the lived experience of re-engaging with life after attempted suicide?”
The past focus on understanding the rates, causes, and risks of suicide has not been effective in reducing suicide rates. There is an identified need for more research into the “lived experience” of people who have attempted suicide. The methodology underpinning this thesis is descriptive phenomenology in the tradition of Edmond Husserl.
Information came from taped, face-to-face, semi-structured interviews of one to two hours with eight participants: adult volunteers who shared their experience of the phenomenon. Analysis of participants’ transcripts of interview utilised Colaizzi’s (1978) analytic process. Eight central themes emerged in relation to how people re-engage with life after attempted suicide. These are: “The immediate aftermath”; “Doing the work”; “Life reshaping into something new”; “Finding a place to be”; “New ways of seeing”; “New ways of being”; “Making a difference”; and “In the long run.” The findings in the current study have the potential to make a substantive contribution to existing knowledge about the phenomenon of re-engaging with life after attempted suicide.

Jackson, K. (2016). Words of wisdom from those who lived to tell the tale: A descriptive phenomenological study of re-engaging with life after attempted suicide. (Thesis). Central Queensland University. Retrieved from http://hdl.cqu.edu.au/10018/1212309

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Jackson, KP. “Words of wisdom from those who lived to tell the tale: A descriptive phenomenological study of re-engaging with life after attempted suicide.” 2016. Thesis, Central Queensland University. Accessed September 15, 2019.
http://hdl.cqu.edu.au/10018/1212309.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Jackson, KP. “Words of wisdom from those who lived to tell the tale: A descriptive phenomenological study of re-engaging with life after attempted suicide.” 2016. Web. 15 Sep 2019.

Vancouver:

Jackson K. Words of wisdom from those who lived to tell the tale: A descriptive phenomenological study of re-engaging with life after attempted suicide. [Internet] [Thesis]. Central Queensland University; 2016. [cited 2019 Sep 15].
Available from: http://hdl.cqu.edu.au/10018/1212309.

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Jackson K. Words of wisdom from those who lived to tell the tale: A descriptive phenomenological study of re-engaging with life after attempted suicide. [Thesis]. Central Queensland University; 2016. Available from: http://hdl.cqu.edu.au/10018/1212309

Note: this citation may be lacking information needed for this citation format:Not specified: Masters Thesis or Doctoral Dissertation

▼ Aim
To explore MentalHealth Care Practitioners and a MentalHealth Care Directors perceptions of
mentalhealth care nurses obtaining prescription authority in eThekwini District KwaZulu-Natal.
Methodology
A qualitative design was used to gather data through individual interviews and a focus group
interview. Purposive sampling was used to select the study setting (five (5) Out Patient
Departments, two (2) Community Health Centres, one (1) tertiary educational institution, and
one district office), potential participants were not sampled. Participants included; twenty six
mentalhealth care nurses (n=26), one (1) psychiatrist (n=1), four (4) medical officers (n=4) and
one (n=1) mentalhealth care director. Thematic analysis using the steps outlined by Braun and
Clark (2006) was used to analyse the data.
Results
The majority of participants were not aware of policies or legislation allowing nurses to prescribe
medication. Participating mentalhealth care nurses from an education setting were more
knowledgeable than other participants about current legislation and policy. Study findings
indicate that nurses’ obtaining prescriptive authority is not on the provincial department of health
agenda. In addition, participating ppsychiatrists and medical officers expressed reservations
about nurses obtaining prescriptive authority, specifically independent prescriptive authority.
Participating mentalhealth nurses displayed ambivalence related to the pursuit of prescriptive
authority.
Conclusion and Recommendations
The challenge for mentalhealth nurses is suggested to be the achievement of a collaborative
working relationship within the discipline of nursing, and between the discipline of nursing and
medicine / psychiatry. It is suggested mentalhealth care directors, and the SANC, be proactive,
look to the future in advising the health minister about access and barriers to mentalhealth care
treatment. In addition, the SANC champion the nurse, specifically the mentalhealth care nurse in
obtaining prescriptive authority for schedule 5-6 psychotropic medications. Further research is required to generate more in-depth data, specifically research that explores mentalhealth care
nurses’ reluctance to pursue prescriptive authority.
Advisors/Committee Members: Smith, A. A. H (advisor).

▼ Aim
To describe psychiatric nursing students‟ stereotypical beliefs associated with mental illness labels and the potential mediating effects of information provided from curriculum content and contact through clinical placement.
Methodology
Four nursing campuses were sampled, resulting in one hundred and thirty two (n=132) participants. Participants remained the same for all three phases of the repeated measure. A quantitative approach, non-experimental survey design with repeated measures made use of a self-report questionnaire. Section A included demographic data (age, gender and cultural group), while Section B consisted of a semantic differential measure (SDM) focusing on three mental illness labels; schizophrenia, major depressive disorder and bipolar mood disorder. Data was collected on the first day of the psychiatric nursing training block, the last day of the training block, and the first day of the second training block, after approximately six weeks of clinical placement in specialist psychiatric settings.
Results
Participant scores suggested greater negative stereotypical beliefs associated with the schizophrenia label in all the three phases of data collection. The bipolar mood disorder label was the least associated with negative stereotypical beliefs. Information given during the initial teaching block and contact during the clinical placement period resulted in a slight reduction of negative stereotypical beliefs associated with the schizophrenic label. In contrast negative stereotypical beliefs associated with the bipolar mood disorder label were increased slightly after information and contact.
Conclusion and recommendation
The results of the study confirmed that health care professionals are not different from the general population in their negative stereotypical beliefs towards mental illness labels. A review of the proposed new nursing curriculum should specifically include emphasis on psychosocial rehabilitation. In addition, clinical placement of the student nurses must be designed to ensure interaction with mentalhealth care users engaged in recovery and community integration to remove perceptions of inability to recover associated with mental
illness labels (Adewuya & Oguntade, 2007; Adewuya & Makanjuola, 2008; Corrigan, 2007; Smith, 2010).
Advisors/Committee Members: Smith, A. A. H (advisor).